28 research outputs found
A regional informatics platform for coordinated antibiotic resistant infection tracking, alerting and prevention
Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region.
Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010.
Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%–23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems.
Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission
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Direct Production of Silicones From Sand
Silicon, in the form of silica and silicates, is the second most abundant element in the earth's crust. However the synthesis of silicones (scheme 1) and almost all organosilicon chemistry is only accessible through elemental silicon. Silicon dioxide (sand or quartz) is converted to chemical-grade elemental silicon in an energy intensive reduction process, a result of the exceptional thermodynamic stability of silica. Then, the silicon is reacted with methyl chloride to give a mixture of methylchlorosilanes catalyzed by cooper containing a variety of tract metals such as tin, zinc etc. The so-called direct process was first discovered at GE in 1940. The methylchlorosilanes are distilled to purify and separate the major reaction components, the most important of which is dimethyldichlorosilane. Polymerization of dimethyldichlorosilane by controlled hydrolysis results in the formation of silicone polymers. Worldwide, the silicones industry produces about 1.3 billion pounds of the basic silicon polymer, polydimethylsiloxane